Wade Christiansen was an Army veteran who served in Afghanistan. He committed suicide in Bozeman, Mont., on May 29. (Adrian Sanchez-Gonzalez / AP)

BOZEMAN, MONT. — Wade Christiansen dreamed of being a soldier from a young age. He joined the Army’s 82nd Airborne Division after high school. Being a paratrooper made Wade proud. Jumping from airplanes excited the daredevil from Red Lodge. In 2009, his unit deployed to Afghanistan.

During a mission, Christiansen’s squad was attacked with a string of six improvised explosive devices. The left side of Christiansen’s jaw was so badly injured it was replaced with titanium. His arm, face and neck were peppered with shrapnel, and the retina in his left eye detached. Two of his colleagues were killed. Emotional and physical injuries became a permanent part of his life.

After Christiansen was discharged from the military, he moved to Four Corners and attended Montana State University as a photography student. He began working with Operation Second Chance, a group that helps disabled veterans, first as a client and later as a peer counselor.

“Ninety-nine percent of the time, he was his great normal self, but there was that 1 percent of the time he would get off his meds, or there would be a day when he’d be waiting for a shipment from the VA and he’d get very, very down,” said his brother, Matt Christiansen.

On May 28, Wade was with his girlfriend in the living room of the home he shared with his brother. Around 1:30 a.m., Wade reversed his Jeep out of the garage, hitting the door as his girlfriend tried to close it. Wade’s brother and girlfriend frantically tried reaching him on his cellphone, knowing Wade was in trouble.

When Wade finally picked up the phone, he told his girlfriend he was on his way to the hospital’s emergency room to kill himself.

On his way, Wade was pulled over by the police for running a red light. Two minutes later, Wade used his pistol to take his own life in the middle of Main Street in Bozeman. He was 23 years old.

The Montana Department of Public Health and Human Services reports that the rate of veteran suicides in 2010 was 66.5 per 100,000 people, more than five times the national suicide rate.

The veteran suicide rate in Montana was nearly triple the regular suicide rate in the state in 2010, according to the American Association of Suicidology. Montana’s rate of suicide is 22.9 suicides per 100,000 people, third highest in the nation.

Between 2003 and 2012, at least 530 of Montana’s veterans of all wars have committed suicide, a figure 13 times greater than the 40 Montana troops who have died in Afghanistan and Iraq.

Common to the top-ranking suicide states are several factors: social isolation, alcohol abuse, access to firearms, and the “cowboy mentality,” a nickname for the way people stigmatize suicide and depression.

“From what I hear talking to soldiers is suicide is a big issue at the Pentagon because it sheds a bad light on the military. But the bottom line with middle management is they still have a job to do. Even if you’re depressed that doesn’t stop you from protecting the country, so I think there’s still a lot of pressure to say OK, you’re depressed, now get over it,” said Karl Rosston, the state’s suicide prevention coordinator.

Casey Elder is a 29-year-old veteran from Bozeman diagnosed with post-traumatic stress disorder and a traumatic brain injury. On April 13, 2004, Elder was working as the turret gunner in a Humvee near Baghdad. When her convoy was hit by an IED, Elder was injured.

“When I got home in June, I moved into my own apartment and everything was good. Then I saw a commercial for butter,” said Elder. “It triggered my first panic attack. I just kept thinking I might not have ever made toast with my mother again.”

Elder became engulfed in anxiety. It took her years of counseling to get her life back, but the process was helped because of her supportive friends and family. Learning she had a traumatic brain injury was a much harder process. After flunking out of MSU twice, Elder said she blamed herself for being too stupid. Then her mother shared some research she had found on traumatic brain injuries.

“I went undiagnosed for more than four years because at the time I got out it wasn’t screened for. But I came to realize I had no short-term memory and I still have visual spatial issues, which made reading difficult for me,” Elder said. “And I have some issues with abstract thinking. Like I know how to drive somewhere, but it’s hard to explain how to get from point A to point B.”

While Elder never became suicidal, she would sometimes imagine dying. Eventually she found support from the National Alliance on Mental Illness in Billings. Counselors there and another at the Fort Harrison Veterans Affairs center helped her overcome her invisible injuries.

Like Elder, Ryan Ranalli of Helena also saw action in Iraq. The former infantryman was on patrol in Mosul when his convoy was ambushed. The initial blast killed a colleague and “rattled” Ranalli. After reenlisting, Ranalli began having seizures that led to a diagnosis of traumatic brain injury and post-traumatic stress disorder. After being medically discharged, Ranalli said he would drink himself to sleep, picked fights at bars and struggled with his emotions.

Despite treatment, Ranalli said he attempted suicide last April.

“I tied parachute cord around the beams in the garage and was trying to step off a saw-horse when my wife found me,” said Ranalli. “She was able to get my dad, who cut me down. I was so drunk I don’t even remember it.”

Ranalli, who has since stopped drinking, became an advocate for veterans with mental health issues. He said he knows seven other veterans from Iraq and Afghanistan who died by suicide, six of them within a 13-month span.

Matthew Kuntz , state director of the National Alliance on Mental Illness, said his stepbrother, Chris Dana, committed suicide after coming home from Iraq.

“Everybody knew Chris had post-traumatic stress disorder, but no one realized how dangerous it was,” Kuntz said. “I thought I had him lined up to get treatment from the VA, but he never went.”

Kuntz said one of the biggest challenges is with the way potential suicide victims are identified. Mandatory self-screenings before and after deployments are a step forward, but at-risk people are not always showing symptoms or hide their problem.

Veterans like Christiansen, Elder and Ranalli are still susceptible to episodes of depression, even after counseling and treatment.

“Wade’s psychiatrist had said he was stable months before his suicide,” his brother said.

Nationwide, about 950 veterans attempt suicide every month, with two-thirds succeeding. According to a national Veterans Affairs study, 22 veterans kill themselves every day. In Montana, slightly more than one veteran commits suicide every week.

Rosston, who has worked with the Montana National Guard to screen for mental health issues, said he’s seen more than 130 soldiers in one day, and about 10 to 20 might be flagged for further screening. “It’s inadequate, but it’s better than nothing,” he said.

Experts agree that Montana has a shortage of mental health professionals, especially in rural areas like eastern Montana.

“There are a couple of different reasons for the shortage,” said Joe Foster, director of Montana Veterans Affairs. “The rural lifestyle, there’s not a lot of folks who want to move here because nationwide there’s a shortage, so they can pick where they live. And the reimbursement rates are not as high as they are in private practice.”

Bowman Smelko, a psychiatrist who treats veterans in Montana, agreed the lack of professionals is an issue, but he said behavioral therapy and prescription drugs currently used to treat veterans could be replaced with other techniques.

Smelko believes new treatments such as testing electrical brain activity in veterans with post-traumatic stress disorder and traumatic brain injury should be expanded.

“We haven’t tried everything, and at some point, we need to ask ourselves if what we’re doing is working,” he said.